In FY 2014, for the fifth consecutive year, the Department of Justice (“DOJ”) recovered more than US$2 billion from healthcare entities in False Claims Act (“FCA”) cases.
The federal government collected a total of US$5.69 billion overall in FCA actions in FY 2014, and US$2.3 billion of that amount was from healthcare-related FCA actions, according to a Department of Justice press release. The DOJ attributes these large healthcare recoveries to “the high priority the Obama Administration has placed on fighting health care fraud.” The FY 2014 figure represents a slight decrease from the US$2.6 billion recovered from healthcare entities in FY 2013.
Whistleblowers continue to play a major role in FCA actions against healthcare entities. Qui tam actions accounted for the vast majority, or US$2.22 billion, of the US$2.3 billion recovered in FY 2014. In addition, as in the past, the vast majority of new healthcare FCA cases initiated in FY 2014—469 out of 500 cases—were brought by whistleblowers, indicating that whistleblowers continue to play a major role in identifying potential fraud in the healthcare industry.
Whistleblowers received more than US$340 million from healthcare-related FCA judgments and settlements in FY 2014.
The pharmaceutical industry comprised a large portion of healthcare-related FCA recoveries, including cases involving alleged illegal promotion and kickbacks. Hospital settlements also figured prominently in FY 2014 FCA recoveries, with US$333 million recovered in various hospital settlements and judgments.